UNIVERSITI PUTRA MALAYSIA

PATTERN OF HAEMATOLOGY AND SERUM BIOCHEMISTRY

PARAMETERS IN CATS SUSPECTED OF FELINE INFECTIOUS PERITONITIS PRESENTED TO UNIVERSITY VETERINARY

HOSPITAL, UNIVERSITI PUTRA MALAYSIA FROM THE YEAR 2014 TO 2016

JONG CHEE ZUNG

FPV 2017 20

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PATTERN OF HAEMATOLOGY AND SERUM BIOCHEMISTRY

PARAMETERS IN CATS SUSPECTED OF FELINE INFECTIOUS

PERITONITIS PRESENTED TO UNIVERSITY VETERINARY HOSPITAL,

UNIVERSITI PUTRA MALAYSIA FROM THE YEAR 2014 TO 2016

JONG CHEE ZUNG

A project paper submitted to the

Faculty of Veterinary Medicine, Universiti Putra Malaysia

In partial fulfilment of the requirement for the

DEGREE OF DOCTOR OF VETERINARY MEDICINE

Universiti Putra Malaysia

Serdang, Selangor Darul Ehsan.

MARCH 2017

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CERTIFICATION

It is hereby certified that we have read this project paper entitled ―Pattern of

Haematology and Serum Biochemistry Parameters in Cats Suspected of Feline

Infectious Peritonitis presented to University Veterinary Hospital, Universiti Putra

Malaysia from the year 2014 to 2016‖, by Jong Chee Zung and in our opinion it is

satisfactory in terms of scope, quality, and presentation as partial fulfilment of the

requirement for the course VPD 4999 – Final Year Project.

ASSOC. PROF. DR. HAZILAWATI HJ. HAMZAH

D.V.M. (UPM), M.V.Sc. (UPM), PhD (Murdoch)

Head of Department

Department of Veterinary Pathology and Microbiology

Faculty of Veterinary Medicine

Universiti Putra Malaysia

(Supervisor)

ASSOC. PROF. DR. GOH YONG MENG

D.V.M, PhD (UPM)

Head of Department

Department of Veterinary Preclinical Sciences

Faculty of Veterinary Medicine

Universiti Putra Malaysia

(Co-Supervisor)

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DEDICATIONS

This project is dedicated to the One Almighty God, who created me and made

all things possible,

To my beloved family,

Late father, Dr. Jong Kim Hock

Mother, Hu Hock Lai

Sister, Grace Jong

Brother, Daniel Jong

And to all my respectful lecturers and staff who have committed themselves towards

the noble cause of education

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ACKNOWLEDGEMENTS

It has indeed been a period of intense learning for me, not only in the

scientific arena, but on a personal level. Writing this thesis has had a huge impact on

me and I would like to reflect on the people who have directly or indirectly helped

me along the way.

I would first like to thank my Abba Father for being gracious in providing

everything and be my spiritual support during times of hardship.

My utmost gratitude to my dearest supervisor, Assoc. Prof. Dr. Hazilawati

Hamzah for her guidance, wisdom, never-ending support, and understanding

throughout this project.

My sincere thanks also goes to my co-supervisor, Assoc. Prof. Dr. Goh Yong

Meng for his knowledge and guidance especially in statistical analysis.

Besides my supervisors, this project would not have been possible without

assistance from the staff of University Veterinary Hospital, UPM as well as Clinical

Pathology Laboratory, UPM in collecting data and information.

Next, I would like to thank my family members who gave me full support

and always be there for me whenever I need a shoulder to rely on during the

accomplishment of this project.

Lastly, not forgetting Dr. Lau Seng Fong, Dr. Khor Kuan Hua, Winniesa, Joy

Lee and my other friends who lend me a helping hand when I needed throughout this

project. Thank you.

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CONTENTS

TITLE……………………………………………………………………… i

CERTIFICATION………………………………………………………… ii

DEDICATION……………………………………………………………..iii

ACKNOWLEDGEMENTS……………………………………………….iv

CONTENTS…………………………………………………………..…… v

LIST OF TABLES……………………………………………………….... vii

LIST OF FIGURES…………………………………………………..…... viii

LIST OF ABBREVIATIONS………………………………………..…… ix

ABSTRAK……………………………………………………………........x

ABSTRACT………………………………………………………….……. xii

1.0 INTRODUCTION……………………………………………….…… 1

2.0 LITERATURE REVIEW………………………………………..…... 3

2.1 Causative agents of FIP……………………………………….……3

2.2 Epizootiology of FIP………………………………………………. 3

2.3 Pathogenesis of FIP………………………………………….…….. 4

2.4 Clinical manifestations of FIP………………………………….….. 5

2.5 Diagnosis……………………………………………………….….. 6

2.6 Treatment and prevention of FIP………………………………......6

3 MATERIAL AND METHODS……………………………………… 8

3.1Case selection……………………………………………………… 8

3.2 Case classification…………………………………………………. 8

3.3 Data collection……………………………………………………... 9

3.4 Statistical analysis…………………………………………………..9

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4.0 RESULTS……………………………………………………………… 11

4.1 Cases……………………………………………………………….. 11

4.2 Descriptive data of patient signalment……………………………... 11

4.3 Pattern of haematological parameters……………………………… 13

4.4 Pattern of serum biochemical parameters………………………….. 15

4.5 Comparison of parameters between dry form and wet form FIP….. 16

5.0 DISCUSSION…………………………………………………………. 19

6.0 CONCLUSION…………………………………….…………………..25

7.0 RECOMMENDATIONS……………………………………………...25

REFERENCES……………………………………………………………. 26

APPENDICES…………………………………………………………….. 31

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LIST OF TABLES

Table 1: Type of FIP among suspected FIP cats……………………………… 13

Table 2: Mean for haematological parameters in suspected FIP cats……….… 14

Table 3: Mean for serum biochemical parameters in suspected FIP cats……... 15

Table 4: Mean for haematological and serum biochemical parameters in

wet form and dry form FIP…………………………………………...16

Table 5: Risk analysis for haematological and serum biochemical parameters ‗cut-

off‘ value for the differentiation of wet form and dry form FIP..18

Table 6: Patient signalment and FCoV antibody titer for suspected FIP cats

presented to UVH, UPM from 2014-2016…………………………… 31

Table 7: Haematological parameters for suspected FIP cats presented to

UVH, UPM from 2014-2016………………………………………… 34

Table 8: Serum biochemical parameters for suspected FIP cats presented to

UVH, UPM from 2014-2016…………………………………………. 38

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LIST OF FIGURES

Figure 1: Sex distribution of suspected FIP cats………………………….… 11

Figure 2: Age group of suspected FIP cats…………………………………. 12

Figure 3: Breed distribution of suspected FIP cats…………………………. 12

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LIST OF ABBREVIATIONS

Abbreviation Meaning

ALP Alkaline Phosphatase

ALT Alanine Aminotransferase

A:G Albumin to Globulin Ratio

ASH American Shorthair

BSH British Shorthair

CI Confidence Interval

DLH Domestic Longhair

DSH Domestic Shorthair

ELISA Enzyme-linked Immunosorbent Assays

FCoV Feline Coronavirus

FECV Feline Enteric Coronavirus

FIP Feline Infectious Peritonitis

FIPV Feline Infectious Peritonitis Virus

RBC Red Blood Cell

OR Odds Ratio

P P-value

PCV Packed Cell Volume

S.D. Standard Deviation

UPM Universiti Putra Malaysia

UVH University Veterinary Hospital

WBC White Blood Cell

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ABSTRAK

Abstrak daripada kertas yang dikemukakan kepada Fakulti Perubatan Veterinar

untuk memenuhi sebahagian daripada keperluan Kursus VPD 4999 – Projek Ilmiah

Tahun Akhir

CORAK HEMATOLOGI DAN SERUM BIOKIMIA PARAMETER DALAM

KUCING YANG DISYAKI RADANG PERITONEUM BERJANGKIT FELIN

YANG DIKEMUKAKAN KE HOSPITAL VETERINAR UNIVERSITI,

UNIVERSITI PUTRA MALAYSIA DARI TAHUN 2014 HINGGA 2016

Oleh

Jong Chee Zung

2017

Penyelia: Prof. MadyaDr. Hazilawati Hj. Hamzah

Penyelia Bersama: Prof. MadyaDr. Goh Yong Meng

Radang peritoneumberjangkit felin (FIP) adalah penyakit immunopatologi maut

yang disebabkan oleh felin koronavirusbermutasi yangdijumpai dalam kedua-dua

kucing liar dan jinak.Kini, kajian tempatan pada corak hematologi dan

serumbiokimia parameter pada kucing FIP adalah amat terhad.Oleh itu, kajian ini

dijalankan untuk menentukan corak hematologi dan serumbiokimia parameter pada

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kucing yang disyaki FIP yang dikemukakan ke UVH, UPM dan juga untuk membuat

perbandingan pada parameter tersebut antara FIP jenis basah dan FIP jenis

keing.Rekod perubatan kucing yang disyaki FIP dengan sejarah dan latar belakang

sertajumpaan klinikal dari tahun 2014 hingga 2016 telah dikaji dankriteria

kemasukan tunggal adalah kucing yang diuji antibodi terhadap FCoV dengan

menggunakan dot-ELISA, Biogal’s Immunocomb® Feline Coronavirus Antibody

Test Kitdan mempunyai sederhana hingga tinggi positif FCoV titer antibodi (S3-S6).

Data pesakit (umur, jantina dan baka), keputusan hematologi dan serum biokimia

telah diperoleh. Antara 132 kucing yang disyaki FIP, 81.1% mempunyai

hiperproteinemia, 88.6% mempunyai hiperglobulinemia, 97.7% mempunyai

nisbahA:G ≤ 0.8 dan 46.2% mempunyai hipoalbuminemia dalam keputusan serum

biokimia manakala 47.8% mempunyai neutrofilia dengan peralihan kiri, 44.7%

mempunyai limfopenia, 41.7% mempunyai monositosis, 55.3% mempunyai

eosinopenia, dan 31.8% mempunyai anemia yang tidak jana semula. Parameter

seperti kiraan limfosit (P = 0.002), kiraan eosinofil (P = 0.009), jumlah protein (P =

0.000), albumin (P = 0.000), globulin (P = 0.041), ALT (P = 0.016), ALP ( P = 0.025)

dan creatinine (P = 0.047) didapati berbeza dangan nyata sekali antara FIP jenis

kering dan FIP jenis basah.

Kata Kunci: Radang peritoneumberjangkit felin, hiperproteinemia,

hyperglobulinemia

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ABSTRACT

An abstract of the project paper presented to the Faculty of Veterinary Medicine,

UPM in partial fulfilment for the course of VPD 4999- Final Year Project

PATTERN OF HAEMATOLOGY AND SERUM BIOCHEMISTRY

PARAMETERS IN CATS SUSPECTED OF FELINE INFECTIOUS

PERITONITIS PRESENTED TO UNIVERSITY VETERINARY HOSPITAL,

UNIVERSITI PUTRA MALAYSIA FROM THE YEAR 2014 TO 2016

By

Jong Chee Zung

2017

Supervisor: Assoc. Prof. Dr. Hazilawati Hj. Hamzah

Co-supervisor: Assoc. Prof. Dr. Goh Yong Meng

Feline Infectious Peritonitis (FIP) is a lethal immunopathological disease caused by

mutated feline enteric coronavirus found in both wild and domesticated cats. There

are limited local studies on the pattern of haematological and serum biochemical

parameters in FIP cats. Thus, this study was conducted to determine the pattern of

haematological and serum biochemical parameters in suspected FIP cats presented to

UVH, UPM and also to compare these parameters between dry form and wet form

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FIP. Medical records of cats suspected of FIP with compatible history and clinical

signs admitted to UVH from year 2014 to 2016 were reviewed and the sole inclusion

criterion was cats tested for FCoV antibody using dot-ELISA, Biogal‘s

Immunocomb® Feline Coronavirus Antibody Test Kit with medium to high positive

FCoV antibody titre (S3-S6). Data on signalment (age, sex and breed), haematology

and serum biochemistry results were obtained. Among the 132 suspected FIP cats,

81.1% had hyperproteinaemia, 88.6% had hyperglobulinaemia, 97.7% had A:G

ratio≤ 0.8 and46.2% had hypoalbuminaemia, 47.8% had neutrophilia with left shift,

44.7% had lymphopaenia, 41.7% had monocytosis, 55.3% had eosinopaenia, and

31.8% had nonregenerative anaemia. Parameters such as lymphocyte count

(P=0.002), eosinophil count (P=0.009), total protein (P=0.000), albumin (P=0.000),

globulin (P=0.041), ALT (P=0.016), ALP (P=0.025) and creatinine (P=0.047) were

found to be significantly different between dry form and wet form FIP.

Keywords: Feline infectious peritonitis, hyperproteinaemia, hyperglobulinaem

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1.0 INTRODUCTION

Feline Infectious Peritonitis (FIP) is a lethal immunopathological disease

characterized as an immune-mediated pyogranulomatous vasculitis caused by

mutated feline coronavirus (FCoV), known as feline infectious peritonitis virus

(FIPV) which can be found in both wild and domesticated Felidae (Pedersen &

Floyd, 1985; IDEXX, 2015). Its morbidity is low and barely surpasses 5% of

infected cats despite the generally high prevalence of FCoV infection in the cat

population, which can exceed 90% in multicat environment (reviewed by Pedersen,

2009).

Several studies reported FIP significantly more often in male cats (Rohrbach

et al., 2001; Norris et al., 2005) and approximately 50% of FIP cats diagnosed

worldwide are less than 2 years old with over representation of purebred cats (Norris

et al., 2005). FIP isdivided into two distinct clinical forms which are dry form and

wet form (Goodson et al., 2009). Wet form FIP is caused by complement-mediated

vasculitis initiated by immune complex deposition in vessel walls while dry form

FIP results when a cell-mediated immune response dominates and granulomas form

in various organs (Pesteanu-Somogyi, 2005).

Nonregenerative anaemia, neutrophilic leukocytosis, lymphopaenia and

hyperproteinaemia are well-recognized haematological and serum biochemical

findings in FIP (Jain, 1993; Pedersen, 1995). In Malaysia, there is limited study on

the pattern of haematological and serum biochemical parameters in FIP cats.

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Moreover, data regarding comparison of these parameters between dry form and wet

form FIP cats are also lacking. Thus, this study was conducted with the following

objectives:

i. to determine the pattern of haematological and serum biochemical parameters

in cats suspected of FIP presented to UVH, UPM

ii. to compare the haematological and serum biochemical parameters in cats

suspected of dry form and wet form FIP.

Significant differences for certain parameters between dry form and wet form FIP

might contribute to its diagnostic value.

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